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Volume 54, Issue 6
Displaying 1-7 of 7 articles from this issue
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Original Articles
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Akihito Otsuka, Koichiro Takeda, Satoko Kubo, KOLABO Study Group2011 Volume 54 Issue 6 Pages 399-405
Published: 2011
Released on J-STAGE: July 15, 2011
JOURNAL FREE ACCESSWe studied the effects of changing from an angiotensin II type 1 receptor blocker (ARB) to combined losartan (50 mg) and hydrochlorothiazide (12.5 mg) on blood pressure, renal status, and metabolism in subjects with type 2 diabetes and uncontrolled hypertension, i.e., systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg. Subjects numbered 84 outpatients taking a usual dose of ARB were enrolled and followed up for 6 months in open observation. Blood pressure and HbA1c (JDS) were measured monthly. Blood pressure decreased significantly during these 6 months from an average of 151/82 mmHg at baseline to 136/73 mmHg. HbA1c increased significantly 0.2% in 1 to 5 months. Biomedical markers measured every three months showed a mild but significant increase in uric acid and decrease in HDL cholesterol and potassium. Urinary albumin creatinine ratio and estimated glomerular filtration rate decreased significantly with significant correlatim between their changes. In conclusion, changing from an ARB to losartan/hydrochlorothiazide markedly reduced blood pressure with renal protection and mildly adverse effects on metabolism in subjects with type 2 diabetes and uncontrolled hypertension.
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Case Reports
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S. Taniguchi, H. Matsumura, H. Mitsui, K. Nakayama, T. Kawano, K. Kato ...2011 Volume 54 Issue 6 Pages 406-410
Published: 2011
Released on J-STAGE: July 15, 2011
JOURNAL FREE ACCESS -
Tomoji Yuno, Emiko Kawabata, Takahiro Matsumura, Yukimasa Hisada, Yasu ...2011 Volume 54 Issue 6 Pages 411-416
Published: 2011
Released on J-STAGE: July 15, 2011
JOURNAL FREE ACCESSWe report a case of ammonium acid urate uraturia in diabetic ketoacidosis, not before reported. A 39-year-old woman diagnosed with and treated for type 1 diabetes since 2000 had decided to discontinue insulin, making her glycemic control poor. Developing general fatigue and vomiting on January 31, 2010, she reduced insulin as she liked, resting in bed while hydrated. Her primary care physician, visiting her at home on February 1, 2010, diagnosed her with diabetic ketoacidosis, then had her taken by ambulance to our hospital. On hospital day (HOD) 2 after admission, urinary sediment showed numerous ammonium acid urate crystals. Her condition, along with her abnormal initial tubular function markers, improved in a few days. Ammonium acid urate crystals form stones rapidly and reports of cases with postrenal acute renal failure due to stones have increased. Considering the crystal formation mechanism, the risk is high in diabetic ketoacidosis and detecting crystals in urinalysis appears meaningful.
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Fumie Sakamoto, Akio Kuroda, Satoshi Kawashima, Ken Kato, Eriko Ueda, ...2011 Volume 54 Issue 6 Pages 417-424
Published: 2011
Released on J-STAGE: July 15, 2011
JOURNAL FREE ACCESSPancreas transplantation in Japan ostensibly requires that the donor have “no history of diabetes.” We report a case in which, following a kidney transplant, the subject had a pancreas transplanted from a donor suspected of being glucose-intolerant and became insulin-independent postoperatively. A man in his 30's developing Type 1 diabetes mellitus in 1982, undergoing hemodialysis for end-stage renal disease in 2004 and a living-donor kidney transplant from his mother in September 2005. The pancreas was transplanted from a cerebral-infarction-induced brain-dead donor on April 5, 2008. The donor had never been diagnosed with diabetes mellitus but had HbA1c of 7.3% at brain death. Despite daily 60-unit insulin dosage before transplant, the subject became insulin-independent and has had undeteriorated renal function for more than one year since the transplant. Postoperative pancreas graft function results in Japan are comparable to those in Europe and North America, and the problem of the almost complete lack of donors remains. This case thus shows the possibility of making pancreas transplant donor criteria more flexible.
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H. Mori, Y. Okada, A. Kurozumi, T. Arao, K. Nishida, Y. Tanaka2011 Volume 54 Issue 6 Pages 425-429
Published: 2011
Released on J-STAGE: July 15, 2011
JOURNAL FREE ACCESS
Co-medicals; Original Article
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M. Yagami, T. Kato, A. Hayashi, R. Wakizaka, K. Kobayashi, K. Washino, ...2011 Volume 54 Issue 6 Pages 430-435
Published: 2011
Released on J-STAGE: July 15, 2011
JOURNAL FREE ACCESS
Proceeding of the Local Society
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2011 Volume 54 Issue 6 Pages 436-473
Published: 2011
Released on J-STAGE: July 15, 2011
JOURNAL FREE ACCESSDownload PDF (1053K)
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